Evidence map›Paper›PMID 40340730›Full record

SynthesisBMC anesthesiology2025

The safety and efficacy of remimazolam, ciprofol, and propofol anesthesia in endoscopy: a systematic review and network meta-analysis.

Siqi Zhou, Shangchen Yu, Yuan Bi, Zhang Tian, Ruochen Pan, Tianqing Yan, Jianbo Deng, Aijun Xu

Abstract readNetwork Meta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. Article
  5. Review
  6. Bayesian statistics: a primer for perioperative medicine clinicians.Perioperative medicine (London, England) · 2026
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Siqi Zhou *Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Shangchen Yu *Department of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Yuan BiDepartment of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Zhang TianDepartment of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ruochen PanDepartment of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Tianqing YanDepartment of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Jianbo DengDepartment of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Aijun XuDepartment of Anesthesiology, Hubei Key Laboratory of Geriatric Anaesthesiaand , Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anaesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. ajxu@tjh.tjmu.edu.cn.ORCID http://orcid.org/0000-0003-4115-3137

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile propofol remains widely used for endoscopic sedation, its cardiovascular depression and injection pain limitations have prompted exploration of novel agents (remimazolam, ciprofol). This study aimed to compare their safety and efficacy profiles systematically.

methodsWe conducted a network meta-analysis to evaluate remimazolam, ciprofol, and propofol for gastrointestinal endoscopy. Bayesian random-effects models were used to estimate relative risks (RR) and mean differences (MD) with 95% credible intervals(CrI).

resultsForty-two randomized controlled trials (N = 10,540 patients) were included. Remimazolam demonstrated superior cardiovascular safety (RR = 0.44, 95%CrI 0.35-0.54 vs propofol) and lowest respiratory depression risk (RR = 0.36, 0.28-0.46). Propofol showed faster recovery (MD -14.22 min, -2.35 to -30.83 vs remimazolam). Both remimazolam (RR = 0.045) and ciprofol (RR = 0.054) significantly reduced injection pain versus propofol.

conclusionRemimazolam should be prioritized for high-risk patients (cardiovascular/respiratory comorbidities) despite slightly longer recovery times. Propofol remains suitable for low-risk procedures requiring rapid turnover, while ciprofol offers balanced efficacy for endoscopy.

trial registrationThe study was registered with the UK National Institute for Health Research's PROSPERO platform (CRD42024569405; https://www.crd.york.ac.uk/prospero/ ).

Indexed as

Anesthetics, IntravenousBenzodiazepinesEndoscopy, GastrointestinalHypnotics and SedativesPropofolCyclopropanesHumansRandomized Controlled Trials as Topic(2-(1R)-1-cyclopropyl)ethyl-6-isopropyl-phenolAnesthetics, IntravenousBenzodiazepinesCyclopropanesHypnotics and SedativesPropofolremimazolamAnesthesiaCiprofolEndoscopyPropofolRemimazolamSedation

Identifiers

PMID40340730
PMCPMC12060368

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.